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Pantoprazole

Sounds like 'pan-top-ra-zole'

Key points about pantoprazole

Pantoprazole is used to treat problems affecting the stomach and gut, such as indigestion, reflux and ulcers.
It belongs to a group of medicines known as proton pump inhibitors.
Pantoprazole is also called Panzop Relief.
Find out how to take it safely and possible side effects.

Pantoprazole reduces the amount of acid produced in your stomach. It belongs to a group of medicines known as proton pump inhibitors (PPIs).

Pantoprazole is used to treat conditions associated with high levels of stomach acid such as indigestion, reflux and ulcers. It can prevent ulcers from forming, or help the healing process where damage has already occurred.
Pantoprazole can be used to prevent ulcers caused by medicines such as non-steroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs are diclofenac, ibuprofen and naproxen.
It can be given together with certain antibiotics to get rid of Helicobacter pylori, a bacteria found in the stomach that can cause ulcers.

Dose

Always take your pantoprazole exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it, and any special instructions.

In New Zealand pantoprazole is available as tablets (20mg and 40 mg).
The usual dose of pantoprazole is 20 to 40 mg once a day.
Your doctor will advise you on how long to take pantoprazole for (usually for 2 to 4 weeks). Some people may need to take it for longer.
It's best to take the lowest effective dose, for the shortest possible time.

How to take pantoprazole

Take pantoprazole at the same time each day. You can take it with or without food, but it may work better if you take it before food.
Swallow your tablet whole with a glass of water. Don't crush or chew the tablet or it won't work properly.
If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.

Avoid long-term use of pantoprazole

If you don’t need it, pantoprazole shouldn't be taken long term because of the possible side effects. There may be a small increased risk of bone fractures, chest infection, gut infection and nutrient deficiencies such as low magnesium and vitamin B12.

If you’ve been taking a PPI for reflux for longer than 4 to 8 weeks, and your symptoms seem to be well managed, it’s a good idea to talk to your healthcare provider about reviewing your medicine. They may recommend reducing your treatment. This could include:

Reducing your daily dose of pantoprazole.
Taking pantoprazole only when you experience the symptoms of heartburn and reflux (also known as on-demand therapy).
Stopping treatment completely, as your symptoms may not return. It may be best to reduce the dose over a few weeks before stopping.

Taking other medicines

Pantoprazole may be affected by medicines or herbal supplements, so check with your doctor or pharmacist before starting any new medicines.

Having an endoscopy

Ask your doctor if you should stop taking pantoprazole a few weeks before your endoscopy. It may hide some of the problems that would usually be spotted during an endoscopy.

Like all medicines, pantoprazole can cause side effects although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Rebound acid secretion when stopping

When pantoprazole is stopped, a common side effect is rebound acid secretion, where the acid secretion in your stomach increases significantly. This should return to normal within 2 weeks. Because the symptoms of rebound acid secretion are the same as those of reflux (such as indigestion, discomfort and pain in your upper stomach and chest, feeling sick and an acid taste in your mouth), it can form an ongoing loop where stopping pantoprazole treatment creates the need to start it again.

Rather than restarting pantoprazole, your doctor may advise you to use antacids such as Acidex, Mylanta or Gaviscon. These can be effective for treating rebound acid secretion.

Other side effects

Side effects	What should I do?
Stomach upset, feeling sick Feeling bloated, gas in your abdomen (tummy), farting Loose stool (mild diarrhoea) Constipation	These are quite common when you first start taking pantoprazole. If you feel sick, try taking pantoprazole with or after a meal or snack. Tell your doctor if these side effects bother you.
Signs of low magnesium, such as muscle cramps, weakness, tiredness, feeling irritable and changes in heartbeat	If you take pantoprazole for more than 3 months, the levels of magnesium in your blood may fall. Tell your doctor if you get these side effects.
Signs of low vitamin B12 such as feeling very tired, a sore and red tongue, mouth ulcers and pins and needles.	This is most likely if you take pantoprazole long-term, on an ongoing basis. Tell your doctor if you get these side effects.
Severe or ongoing diarrhoea (loose, watery, frequent stools)	This can be a sign of an inflamed bowel. Tell your doctor immediately.
Fever and joint pain along with a red skin rash. Rash on parts of your body exposed to the sun, such as your arms, cheeks and nose.	Pantoprazole can cause rare conditions called subacute cutaneous lupus erythematosus and drug-induced photo-sensitivity reactions. They can happen even if you have been taking pantoprazole for a long time. Tell your doctor immediately or phone Healthline 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)